Abstract: (1) Background: Physical activity (PA) is a key modifiable risk factor for chronic diseases, yet many adults do not meet PA guidelines. Just-in-time adaptive interventions (JITAIs), a type of mobile health (mHealth) intervention, offer tailored support based on an individual’s context to promote PA. Integrating behavior change techniques (BCTs) and theories is critical to the design of effective mHealth interventions. Understanding which BCTs and theories work best can inform future JITAI development. (2) Objective: To examine how behavior change theories and BCTs are implemented in mHealth PA JITAIs and assess their relationship to PA-related outcomes. (3) Methods: This scoping review followed the PRISMA-ScR guidelines. A total of 29 studies were included. (4) Results: The most commonly used BCTs include prompts/cues, goal setting (behavior), feedback on behavior, and self-determination theory and social cognitive theory are the most commonly used theory. However, there is insufficient evidence as to which theories and BCTs are most effective in eliciting effective PA behavior change. (5) Conclusion: Clearer re-porting and integration of BCTs and behavior change theories, along with optimized user interfaces, are needed to improve intervention quality, replicability, and long-term effectiveness of PA JITAIs.

Abstract: This study compared cognitive, language, and motor development outcomes among children attending public and private Early Childcare Centers (ECCs), considering birth factors and family and daycare environments. Additionally, it examined the proximal and distal factors influencing children’s development. Cognitive, language, and motor skills were assessed in the children, along with evaluations of ECC quality, teacher practices, and knowledge of child development. Results indicated that children enrolled in public ECCs achieved higher cognitive and language development scores despite coming from families with lower socioeconomic status and having lower birth weights. They also benefited from longer periods of breastfeeding. Teachers in public ECCs demonstrated greater daily practices, providing enhanced movement opportunities for children. Private ECCs offer more suitable outdoor spaces, whereas public ECCs have better indoor spaces. Regression analysis revealed that daily practice, teachers' experience, and the availability of gross motor toys explained 41% of the variance in motor development. The duration of breastfeeding explained 24% of the variance in cognitive development. Teachers' knowledge about children's development and attendance at public ECCs explains 31% of the variance in language development. These findings underscore the importance of prioritizing teacher education in public and private ECCs to optimize children's overall development.

Abstract: Background/Objectives: Previous studies assessing dietary intake have used self-report methods, prone to misreporting. Using researcher-conducted weighed food records, we assessed rural and urban mothers' energy and nutrient intakes and compared them to recommended nutrient intakes (RNIs). Methods: This cross-sectional study was conducted in rural (Asaase Kokoo) and urban (University of Ghana Staff Village) communities. Dietary data were collected from fifty-four mothers (26 rural, 28 urban) on 2 weekdays and 1 weekend day and were analyzed with software, programmed with West African, FNDDS, Kenyan, Ugandan, USDA food composition databases. Results: Mean (SD) ages (years) were 35.8 (11.6) and 44.4 (7.6), and mean energy intakes (kcal) were 2026 (461) and 1669 (385) for rural and urban mothers, respectively. Mean percentage contributions of macronutrients to daily energy intake were within recommended ranges for rural and urban mothers. All participants met or exceeded vitamin A RNI, irrespective of location. While all rural mothers met or exceeded iron RNI, some urban mothers (14.3%) did not. Few rural (7.7%) and urban mothers (10.7%) did not meet zinc RNI. About half of rural (46.2%) and urban mothers (53.6%) did not meet folate RNI. Most rural (96.1%) and urban mothers (92.8%) met or exceeded fiber RNI. Conclusions: Overall, rural mothers had higher energy and nutrient intakes than urban mothers. While most met RNIs, there were some micronutrient inadequacies, particularly folate, where almost half of rural and urban mothers consumed below RNI. Our findings indicate the need for tailored interventions to prevent nutrient deficiencies or excesses in Ghanaian mothers.

Abstract: Cystic fibrosis (CF) is a rare autosomal recessive genetic disease that has a progressive and multisystemic course. The spectrum and frequency of mutations in the gene enco-ding the cystic fibrosis transmembrane conductance regulator (CFTR) varies both in European countries and in other geographical regions. The aim of the our retrospective study was to present the genetic variants identified in a group of 48 patients with CF patients from the Moldova region (Romania), as well as to establish genotype-phenotype correlations. Genetic testing was initially performed for 38 CFTR mutations, and in heterozygous patients or in whom no mutation was detected, CFTR gene sequencing (NGS) was performed.The compound heterozygous genotype was identified in 26 (54.16%) of the patients (one of the alleles being F508del), while 22 (45.83%) patients had the homozygous F508del genotype. The F508del variant was the most frequent (69.79%), followed by: G542X (6.25%, 6/96), c.621 +1G>T (3.12%, 3/96), 1677delTA (3.12%, 3/96), 185+1G->T (3.12%, 3/96), 2184insA (2.08%, 2/96), c.917dupA (2.08%, 2/96) and 3849G>A (2.08%, 2/96). Several new variants were also identified, which had not been reported in other studies from Romania (R1158X, K598*, R347H, c.2589_2599del, R496H, and CFTRdele2). We compared the results obtained with data from the literature and correlated the detected CFTR variant (genotype) with the phenotypic manifestations, highlighting certain particularities present in some patients. Genetic testing allows for early diagnosis and adapted management, including personalized treatment for each patient. Identification of novel unclassified CFTR variants still remains a challenge for clinicians. NGS-based screening of heterozygous healthy carriers is important for both genetic counseling and prenatal diagnosis.

Abstract: Evidence-based practice guides the care nurses provide. With their commitment to a holistic approach to understanding an individual’s health status, should evoke many concerns with patients’ accumulation of risks. Factors, such as low socioeconomic status (SES), are associated with higher rates of stress, inflammation, and chronic disease. As we begin to look further into preventing and treating chronic disease, we aim to identify an upstream biomarker of inflammation. Through a literature review, the relationship between low SES and stress as increasing one’s risk for chronic disease was established with a strong connection. Additionally, the adipokines, leptin and adiponectin, and their ratio, which are upstream biomarkers are influential in downstream inflammatory actions. Using a lifecourse theory approach, we identify interventions at multiple interpersonal and structural levels to mitigate the disparities associated with SES. Assuming that this is an appropriate tool to be used for research and policy, it could be useful in both the clinical as well as government settings for systemic improvement using an evidence-based approach. Additional research is needed to fully gain understanding about the inflammation pathway of leptin and adiponectin. This is discussed in our paper further so targeted interventions can begin to be formulated for use in clinical practice and public policy.

Abstract: : The field of public health and disaster medicine has expanded considerably due to the intensifying effects of climate change, prompting policymakers to examine One Health policy responses. These professionals work within complex social-ecological systems connected to political actors and institutions that undermine climate justice by using systems thinking as analytical tools. Preparedness for climate change involves actions taken to plan and adapt to its One Health impacts. Surveillance strategies involving monitoring, research, and development are crucial for maintaining a stable workforce. The methods of this study utilized an exploratory qualitative design that followed the argumentation approach to climate justice, with the aim of assessing the extent to which the public health sector in a range of diverse countries is involved in developing and implementing climate adaptation policies related to disaster medicine and public health. The PRISMA guidelines for scoping review assessment are in line with the methodological quality checklist and the Cochrane risk of bias. This study presents data on climate and one-health adaptation, detailing how each action was addressed. The criteria for ranking a public health policy response to a climate crisis offer a unique opportunity to enhance future health outcomes and resource allocation. The risks and vulnerabilities of societies to climate impacts and emissions vary significantly by location, depending on local circumstances. The extent and speed of climatic changes are less agreed upon than the scoping of risks and vulnerabilities associated with them and the best strategies to cope with them and manage them overall with One Health.

Abstract: Sleep patterns represent a vital physiological need essential for optimal bodily and mental function. The phenomenon of begadang, defined as a deviation from normal sleep duration and circadian rhythm, has become a widespread habit among adolescents and young adults with serious implications. This study identifies the multifaceted impacts of begadang, including a decline in cognitive function (focus, memory, decision-making) due to the dysregulation of brain networks such as the DMN and FPN, as well as an increased risk of chronic physical diseases like cardiovascular and metabolic conditions. Psychologically, begadang triggers a decrease in emotional stability, stress, anxiety, and depression, as indicated by the high prevalence of mental disorders in the productive age group in Indonesia. Triggering factors include academic pressure, excessive gadget use, and a social environment that supports begadang. Although these impacts have been extensively studied, there remains a significant gap in the literature regarding innovative, engaging, and effectively behavioral change-inducing interventions. The low awareness and reading interest of adolescents regarding the dangers of begadang are major obstacles. This qualitative research adopts a systematic-interpretive literature review approach, analyzing comprehensive secondary data from scientific journals, reference books, official institutional reports, and case studies. Data collection procedures include keyword identification, systematic searches in scientific databases, strict source selection and verification, full-text reading, and critical information extraction with accurate note-taking and citation. Data are analyzed through reduction, thematic categorization, comparative analysis, and conceptual synthesis. The discussion integrates findings with theoretical frameworks, clarifies relationships between concepts, and highlights the urgency of innovative interventions. This research fills the gap by formulating critical and creative ideas, such as the development of the "SleepSync Buddy" application, the #IstirahatKeren (Cool Rest) social media campaign, the establishment of campus-based "Sleep Health Hubs," and the integration of "Sleep Literacy" curriculum. These ideas emphasize proactive, preventive, and community-based approaches to foster a healthy sleep culture. In conclusion, begadang has extensive damaging impacts. Innovative digital and community-based solutions are essential to bridge the knowledge gap and trigger positive behavioral change. This research has limitations as it does not involve quantitative data or longitudinal measurements. Further studies are suggested to explore the actual impact on behavior using mixed methods or field experiments.

Abstract: High-Intensity Interval Training (HIIT) is an efficient exercise modality involving alternating short bouts of intense activity with recovery periods. It is increasingly popular among recreationally active individuals due to its time efficiency and broad health benefits. Literature supports its efficacy in enhancing cardiovascular capacity, promoting fat oxidation, and improving anaerobic performance. Given rising sedentary trends among young adults, HIIT emerges as a practical alternative to traditional endurance training, especially for those with limited training time.Building on this context, the present study investigates the physiological impacts of a structured 6-week HIIT intervention on key fitness markers in recreationally active university students aged 20 to 25. The focus is on changes in maximal oxygen uptake (VO₂ Max), body fat percentage, and lower body muscular power, as reflected by vertical jump performance. By comparing pre- and post-intervention values, the aim is to evaluate HIIT’s benefits across aerobic capacity, body composition, and explosive strength.Thirty recreationally active students (mean age: 22.1 ± 1.6 years) completed a 6-week HIIT program comprising three sessions per week. Each session included 20–25 minutes of high-intensity work intervals at 85–95% HRmax interspersed with active recovery. Assessments of VO₂ Max, vertical jump height, and body fat percentage were conducted before and after the program. Paired sample t-tests evaluated differences, repeated-measures ANOVA tested time effects, and Cohen’s d determined the magnitude of changes.The results demonstrated statistically significant improvements across all measured domains following the intervention. Participants showed enhanced aerobic capacity, increased lower-body muscular power, and reduced body fat percentage. These changes were supported by large effect sizes, confirming the practical relevance of the observed adaptations and reinforcing the efficacy of HIIT as a multidimensional training strategy for recreationally active young adults.In conclusion, this study confirms that HIIT is a potent training modality for enhancing cardiovascular endurance, muscular power, and body composition in recreationally active young adults. Its time efficiency and multi-domain benefits support its integration into youth fitness and health programs.

Abstract: Background: Elastic ankle straps are frequently used to improve ankle stability; however, they often fail to provide adequate support due to material limitations. Therefore, this study aimed to investigate the effects of an ankle stabilization strap applied using a bandaging technique on ankle range of motion, balance, and spatiotemporal gait parame-ters in patients with chronic stroke. Methods: Twenty-eight patients with chronic stroke were randomly assigned to either an ankle stabilization strap with bandaging technique (ASB, n = 14) group or an ankle-foot orthosis (AFO, n = 14) group. Both groups participated in treadmill gait training for 10 minutes per day, five days per week, for four weeks. Outcome measures included ankle dorsiflexion range of motion, total center of pressure displacement, timed up and go test, gait speed, and step length. A mixed-design analysis of variance was used for statistical analysis. Results: All outcome variables showed significant group-by-time interaction effects, and the ASB group exhibited significant within-group improvements after the intervention (p < 0.05). Conclusions: The ankle stabilization strap applied using a bandaging technique effective-ly improved ankle mobility, balance, and gait in patients with chronic stroke, suggesting its potential as a useful intervention in stroke rehabilitation.

Abstract: Objectives: Robotic-assisted segmentectomy (RAS) has proven to be safe and feasible for early-stage lung cancer; nonetheless, its oncologic efficacy and long-term outcomes are still debated. We aimed to explore whether RAS could be an alternative to robot-ic-assisted lobectomy (RAL) in early-stage NSCLC, focusing on long-term outcomes such as 10-year cancer-specific survival (CSS), cumulative rate of relapse (RR), and local recurrence (LR). Methods: Patients undergoing RAS for early-stage NSCLC (clinical stage I) were ana-lyzed from August 2007 to August 2023. A 1:3 propensity score-matched analysis was performed among patients undergoing RAL, based on demographic characteristics and pathological stage. Primary endpoints were CSS, RR, and LR. Results: A total of 40 patients undergoing RAS were retrospectively enrolled. After matching 120 patients undergoing RAL, no significant differences were found in post-operative complications, median operative time, or length of hospital stay. Patients undergoing RAS had comparable 10-year CSS (p=0.90) and RR (p=0.99) to those un-dergoing RAL, whereas 10-year of cumulative incidence of local recurrence (LR) was 11.0% (95% CI: 3.4% – 23.7%) for RAS patients, and 2.8% (95% CI: 0.5% – 8.9%) for RAL patients (p = 0.08). Additionally, RAL provided a significantly higher number of N1 and N2 lymph node retrievals (p < 0.0001 and 0.06, respectively), as well as a high-er number of N2 stations (p = 0.0001). Conclusion: Based on our experiences, even though RAS can ensure excellent long-term outcomes in selected cases of early-stage NSCLC, comparable to RAL, the local recurrence rate was higher in the RAS group.

Abstract: This article explores the concept of fitness from physiological, nutritional, and psychological perspectives, synthesizing scientific and practical insights for comprehensive health enhancement and performance optimization. Physiologically, structured resistance training fosters muscular hypertrophy, improves metabolic efficiency, and reduces injury risk through biomechanically sound movements. Nutritionally, optimal macronutrient timing and evidence-based supplementation significantly facilitate recovery processes and muscular adaptation. Psychologically, long-term adherence to fitness programs depends critically on intrinsic motivation, structured goal-setting strategies, and robust social support. An integrated case study demonstrates practical application, reporting notable improvements in muscular strength (e.g., 16.7% increase in squat and bench press performance), intrinsic motivation (37.8% improvement), and overall metabolic health (e.g., improved lipid profiles). This multidisciplinary approach highlights fitness as a holistic and scientifically validated strategy, widely applicable for sustained health and performance improvements across diverse populations.

Abstract: The iron and steel industries globally have a high prevalence of occupational injuries, which need to be reduced. Obtaining safety climate information from workers assists in understanding the safety status at the workplace. This study aimed to assess the safety climate in iron- and steel-industries, and its association with occupational injuries. A cross-sectional study was conducted in four iron- and steel-industries in Tanzania. Three hundred and twenty-one workers from the production lines and 50 managers/supervisors participated. The data were collected by interviews using the Swahili version of the Nordic Safety Climate questionnaire (NOSACQ-50) and the modified International Labor Organization (ILO) manual on methods for occupational injuries. The managers/supervisors scored higher than the workers in five of the NOSACQ-50 dimensions. Most workers with low scores on safety climates had experienced occupational injuries. Analyses of the workers who had been injured at work, showed that the dimensions ‘management safety priority and ability’, and ‘management safety justice’ were significant predictors of occupational injuries in the iron- and steel-industries, when adjusting for working years and working hours per day. This indicates that safety climate is a predictor of occupational injuries, and it is important to improve the safety priorities and commitments among the employees.

Abstract: Effective diagnostic communication—delivering a diagnosis with clarity, structure, and empathy—remains a challenging competency for many undergraduate medical students. This single-arm pre–post study evaluated a generative artificial-intelligence (GenAI) training module designed to improve diagnostic-communication performance. Thirty clinical-phase students completed two pre-test encounters in which they disclosed a type 2 diabetes mellitus (T2DM) diagnosis to a virtual patient powered by ChatGPT (GPT-4o) and were scored with an eight-domain rubric by blinded raters. They then undertook ten asynchronous GenAI scenarios with automated natural-language feedback, followed seven days later by two post-test consultations with human standardized patients assessed in real time with the same rubric. Mean total performance increased by 36.7 points (95 % CI: 31.4–42.1; p < 0.001), and the proportion of high-performing students rose from 0 % to 70 %. Gains were significant across all domains, most notably in opening the encounter, closure, and diabetes-specific explanation. Multiple regression showed that lower baseline empathy (β = –0.41, p= 0.005) and higher digital self-efficacy (β = 0.35, p= 0.016) inde-pendently predicted greater improvement; gender displayed only a marginal effect. Cluster analysis revealed three learner profiles, with the highest-gain cluster character-ised by low empathy and high digital self-efficacy. Inter-rater reliability was excellent (ICC ≈ 0.90). These findings provide empirical evidence that GenAI-mediated practice can produce meaningful, measurable enhancements in diagnostic-communication skills and may serve as a scalable, individualised adjunct to conventional clinical education.

Abstract: Background: In recent decades, the relationship between mental health and well-being has been explored from many perspectives, with emphasis on the two continua model of health, and in different contexts, with an emphasis on young higher education students. Both mental health and well-being are considered predictors of academic success. This study aims to analyze the relationship between mental health and well-being among first- and fourth-year nursing students. The sample consisted of 473 nursing students from a university in the central region of mainland Portugal. Methods: Data were collected using the short versions of the Depression, Anxiety and Stress Scale (DASS-21) and the Mental Health Continuum-Short Form (MHC-SF). Results: Canonical correlation analysis revealed a significant negative association between psychological distress and mental well-being. The first statistically significant canonical function (p &lt; 0.05; Cr=0.601) was primarily defined by depression (canonical loading = -0.992) in the distress group and emotional well-being (canonical loading = 0.948) in the well-being group. Redundancy analysis confirmed a significant interdependence: variables related to psychological distress explained 27.8% of the variance in well-being, while well-being variables explained 23.8% of the variance in distress. Conclusions: These results reinforce the two continua model, highlighting the need to address both mental health and well-being throughout higher education.

Abstract: Health literacy is crucial for effectively navigating health systems and promoting equitable health outcomes. Multilingual and culturally dual regions present unique challenges for health communication; however, disparities in health literacy within such contexts remain insufficiently explored. This study constitutes the first population-based assessment of health literacy in South Tyrol, a bilingual province in northern Italy, utilizing the validated HLS-EU-Q16 instrument. A stratified random sample of 2,090 residents aged 18 and older was surveyed in 2024. Weighted analyses ensured population representativeness, and scores were analyzed overall, by domain (health care, disease prevention, health promotion), and by language group (German, Italian, multilingual). Regression models incorporating sociodemographic and health-related covariates were employed to identify predictors of health literacy. Half of the population (50.0%) exhibited problematic or inadequate health literacy, with significant differences observed across language groups. Italian speakers demonstrated the highest scores, whereas German speakers scored lowest overall. These differences remained significant after adjustment for age, education, chronic illness, and professional background. Domain-specific analyses revealed distinct patterns: German-speaking respondents scored particularly low in the health promotion domain, while multilingual individuals achieved the highest scores in the prevention and promotion domains. Education level and language background emerged as the strongest predictors of health literacy, while most other covariates exhibited limited explanatory power. The findings underscore the necessity for language-sensitive and domain-specific interventions, highlighting health literacy as both a personal skill and a structural responsibility.

Abstract: A paradigm shift in oncological intervention is proposed, wherein tumor ablation is reframed as a problem of vibrational topology, rather than conventional energy dose or thermal transfer. A nonthermal, contactless strategy is described, employing phase- locked external excitation tuned to the eigenfrequencies of malignant tissues. This approach enables selective accumulation of localized strain along specific vibrational modes, leading to irreversible mechanical collapse restricted to pathological structures, while thermal diffusion, ionizing radiation, and cytotoxic agents are entirely bypassed. In contrast to existing ablation modalities—thermal, cavitation-based, or chem- ical—intrinsic spectral, elastic, and geometric asymmetries of tumors are harnessed to enable precision targeting via spectral detuning, with efficient sparing of healthy stroma. Robust spectral confinement of vibrational energy in tumor analogs is demon- strated by finite-element simulations and multilayer phantom experiments, achieving mechanical quality factors above 30 and collapse events occurring safely below conven- tional thermal limits. Pathologies such as pancreatic and triple-negative breast cancers, typically resis- tant to standard interventions, are shown to exhibit unique modal fingerprints under this framework. This allows highly specific ablation even in infiltrative or surgically inaccessible regions. These findings are believed to establish both mechanistic and translational foundations for a new class of spectral-oncological therapies, integrating vibrational resonance physics with biomedical engineering and image-guided precision for future clinical translation.

Abstract: Background: To reduce work-related illnesses among teachers, various types of programs have been implemented. Objectives: The aim of this study was to evaluate the effects of a multicom-ponent program on mental disorders, biochemical parameters, and immunological markers in overweight female basic education teachers. Methods: A total of 33 female basic education teachers with a body mass index (BMI) ≥ 25 kg/m² participated in the study. Participants were randomly assigned to either a control group (n = 16), which did not participate in the program, or an in-tervention group (n = 17), which underwent the multicomponent intervention. The program in-cluded physical exercise (three sessions per week), cognitive-behavioral therapy delivered monthly across three modules, and nutritional education consisting of both general and specific guidance. Assessments were conducted at baseline and after 12 weeks and included measurements of symptoms of depression, anxiety, and stress; fasting glucose; total cholesterol; LDL-cholesterol; HDL-cholesterol; VLDL-cholesterol; triglycerides; and concentrations of immunoglobulins IgA, IgG, and IgM. Results: After 12 weeks, the intervention group showed a significant reduction in symptoms of depression, anxiety, and stress (p < 0.05), as well as in fasting glucose, triglycerides, and VLDL-cholesterol levels compared to the control group (p < 0.05). No significant changes were observed in the levels of immunoglobulins IgA, IgG, or IgM (p > 0.05). Conclusions: The multi-component program improved mental health and reduced the risk of developing metabolic and cardiovascular diseases in overweight basic education teachers.

Abstract: One of the greatest benefits of inclusion in general physical education (PE) is the opportunity for social interactions between students with and without disabilities. Unfortunately, interviews with children with disabilities who have participated in PE often find that social interactions with students without disabilities were limited. A model that promotes interaction between students with and without disabilities in PE is Special Olympics Unified Physical Education (UPE). In UPE, students with and without disabilities participate in activities together rather than the one-way focus on traditional peer tutoring. There have been anecdotal reports on positive benefits of UPE for both students with and without disabilities. To date, there has been no published research on UPE. Additionally, some question how UPE has been implemented in schools specifically questioning if UPE provided quality PE and whether students with disabilities were forced into UPE and denying opportunities to participate in general PE. The purpose of this qualitative study was to better understand how UPE was developed and implemented in select U.S. schools. Interviews with twelve teachers who were directly involved in their UPE programs revealed the following four major themes: (1) our children were not being served appropriately, (2) mix of PE standards and Special Olympics programming, (3) UPE is a choice, and (4) our students improved in many ways. The discussion examined the results in relation to the criticisms of UPE and how UPE proved to be a positive alternative to limited social interactions in general PE.

Abstract: Background: This review examined and described existing characteristics of education programs which contributed towards the development of an education program for the improvement of QoL of PLHIV on ART. The research question that guided the study was, “What are the characteristics of existing education programs?” Methods: All studies which directly developed a program were assessed for relevance. Only articles written in English from January 2010 to 2021 were retrieved and no authors were contacted. Studies that did not directly develop a program were excluded. The Boolean words “OR” and “AND” were used in conjunction with the following search keywords/ statements: Program development and HIV; Designing an education program and HIV; Development of a program and HIV and education programs and HIV. Critical appraised checklist tools were employed which are Bowling’s and Pearson checklists. Results: Six themes addressing the review question emerged which are needs assessment, program objectives, theory-based methods and strategies, planning and development of the program, program implementation and program evaluation. From the reviewed articles, all thirteen had needs assessment as an initial step in their program development followed by twelve articles which mentioned program implementation and also twelve articles which had a planning and development of a program step. Out of the thirteen articles eleven conducted a program evaluation while nearly half of the articles had program objectives as their second step in development of a program. Conclusions: The findings of this review demonstrated that in the articles searched and reviewed, there were no programs that adequately addressed QoL. This implies that there is no uniform standard in addressing this phenomenon. However, the result suggests important steps to consider when developing a program. Therefore, for a program to be successful and solid, one needs to consider six themes. It is also evident from the review that similar measured results from existing programs can be used to develop education programs that can contribute towards the improvement of QoL of PLHIV on ART.

Abstract: Low rates of actively contributing to the Social Health Insurance Fund (SHIF) under Social Health Authority (SHA) could be due to health insurance knowledge inadequacies possibly due to poor eHealth literacy. This study assesses whether eHealth literacy predicts SHA/SHIF knowledge among undergraduate students in health-related courses in Kenya. An analytical cross-sectional online survey was conducted using the eHealth Literacy Scale (eHEALS) and adapted Kaiser Family Foundation quiz to collect data. A total of 207 tertiary education students mainly pursuing six health courses in 21 institutions in Kenya responded to the survey. The median eHealth literacy score was 3.9/5, with about 54% having high eHealth literacy levels (median ≥ 4). About 9.2% of the students had never heard of SHA/SHIF while only 21.7% had high knowledge of SHA/SHIF (median ≥ 4), with the median knowledge score being 3/5. Only high eHealth literacy compared to low eHealth literacy (OR = 6.2, p&lt;0.0001) and pursuing nursing, public health, and other courses compared to pursuing MBChB (OR = 4.9-5.1, p = 0.01-0.03) significantly predicted SHA/SHIF knowledge. Thus, health students in Kenya had modest eHealth literacy levels and SHA/SHIF knowledge. eHealth literacy was a significant predictor of SHA/SHIF knowledge, thus interventions can target it.