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The study aims to explore how segmentation as a methodology can be adapted to the healthcare context to provide a more nuanced understanding of the served population and to facilitate the design of patient-centric services.

The study was based on a collaborative project with a national healthcare organization following the principles of action design research. The study describes the quantitative segmentation performed during the project, followed by a qualitative interview study of how segments correspond with patient behaviors in an actual healthcare setting, and service design workshops facilitated by segments. A number of design principles are outlined based on the learnings of the project.

The segmentation approach increased understanding of patient variability within the service provider organization and was considered an effective foundation for modular service design. Patient characteristics and life circumstances were related to specific patterns of health behaviors, such as avoidance or passivity, or a persistent proactivity. These patterns influenced the patients' preferred value co-creation role and what type of support patients sought from the care provider.

The proposed segmentation approach is immediately generalizable to further healthcare contexts and similar services: improved understanding of patients, vulnerable patients in particular, improves the fit and inclusivity of services.

The segmentation approach to service design was demonstrated to be effective in a large-scale context. The approach allows service providers to design service options that improve the fit with individual patients' needs for support and autonomy. The results illuminate how patient characteristics influence health and value co-creation behaviors.

This paper brings focus and attention to the aspect of time within health information behaviour. The purpose of this paper is to critically assess and present strengths and weaknesses of utilising the infodemiology approach and metrics as a novel way to examine temporal variations and patterns of online health information behaviour. The approach is shortly exemplified by presenting empirical evidence for temporal patterns of health information behaviour on different time-scales.

A short review of online health information behaviour is presented and methodological barriers to studying the temporal nature of this behaviour are emphasised. To exemplify how the infodemiology approach and metrics can be utilised to examine temporal patterns, and to test the hypothesis of existing rhythmicity of health information behaviour, a brief analysis of longitudinal data from a large discussion forum is analysed.

Clear evidence of robust temporal patterns and variations of online health information behaviour are shown. The paper highlights that focussing on time and the question of when people engage in health information behaviour can have significant consequences.

Studying temporal patterns and trends for health information behaviour can help in creating optimal interventions and health promotion campaigns at optimal times. This can be highly beneficial for positive health outcomes.

A new methodological approach to study online health information behaviour from a temporal perspective, a phenomenon that has previously been neglected, is presented. Providing evidence for rhythmicity can complement existing epidemiological data for a more holistic picture of health and diseases, and their behavioural aspects.

The aim of this study is to assess healthcare workers' behavior on the congenital hypothyroidism screening program implementation based on a framework protocol and its associated factors.

A cross-sectional study was conducted using the multistage random sampling method in recruiting health clinic workers and purposive sampling techniques for hospital workers. The demographics, providers' characteristic, occupational profile, attitude, perceived behavior control (PBC), knowledge, behavioral intention and adherence to protocol were gathered using validated and reliable self-administered questionnaires.

Partial intention to adhere to protocol was 25.7%. Weak attitude (adjusted odds ratio [AOR]: 5.48, 95% confidence interval [CI]: 3.32–9.06), low PBC score (AOR: 0.91, 95% CI: 0.86–0.95) and low knowledge score (AOR: 0.85, 95% CI: 0.75–0.96) were associated with partial intention to adhere to protocol. In the self-rated adherence assessment, 92.6% of participants from health clinics, 79.1% from pediatric and 61.1% from pathology were found not adhering to protocol. There was a significant association between intention and adherence to protocol.

Documentations and observations in assessing program implementation were limited to perform in the present study. Using self-rated instruments and focusing on healthcare workers alone did not provide a comprehensive assessment.

Availability of a training module at site and regular refreshing course training should be made available to harness knowledge, attitude and behavioral perception in implementing the program activities.

Integrating the Logical Framework Approach in assessing program implementation and application of the Theory of Planned Behavior and Attitude, Subjective Norms, Self-Efficacy Model in this study were beneficial.

Health apps offer a potential approach to support healthier food behaviours but a lack of sufficient engagement may limit effectiveness. This study aims to use a user engagement theoretical lens to examine the factors that influence app engagement over time and may prompt disengagement.

A phenomenological exploration of the lived experience was used. Women from a lower socioeconomic background (based on the occupation and employment status of the household’s primary income earner) were randomly assigned to use one of two apps for a minimum of eight weeks. Multiple data collection methods, including accompanied shops, researcher observations, interviews, participant reflective accounts and questionnaires, were used at different time-points to examine engagement. Theoretical thematic analysis was conducted to explore the engagement experience and relevant social, personal and environmental influences.

Healthy food involvement appears to drive app engagement. Changes in situational involvement may contribute to fluctuation in engagement intensity over time as the saliency of personal goals change. Negatively valenced engagement dimensions may contribute to the overall expression of engagement. A lack of congruency with personal goals or an imbalance between perceived personal investment and value was expressed as the primary reasons for disengagement.

Situational involvement may act as a trigger of different engagement phases. There is a need to better distinguish between enduring and situational involvement in engagement research.

Individual characteristics may shape engagement and propensity for disengagement, which highlights the practical importance of incorporating tailored features into app design.

Findings broaden the current conceptualisation of engagement within the digital space and prompt a reconsideration of the role of situational involvement and negatively valenced dimensions throughout the engagement process.

The purpose of this paper is to determine the effectiveness of a modified HBM-based intervention to reduce body mass index (BMI) for age in overweight junior high school students.

A cluster-randomized controlled trial was conducted in the first and second years of a junior high school in the center of Thailand. In total, 24 classrooms were randomly assigned to a modified health belief model intervention arm (HBMIA), and 24 classrooms were randomly assigned to a traditional school health education arm (control). In total, 479 students who were overweight (BMI forage = median +1 SD, aged 12–15 years) participated in the study. The HBMIA used the health belief model (HBM) as a motivator for behavioral strategies that included modifying diet and participating in physical activity. BMI, health knowledge and behavior for preventing obesity were recorded at baseline and at six months. A multilevel regression model was performed to calculate mean difference between HBMIA and control group.

The students who participated in the HBMIA showed a decrease in BMI of 1.76 kg/m², while those who participated in the control showed an increase in BMI of 1.13 kg/m², with a mean difference of –2.88 kg/m² (95% CI =–3.01 to –2.75), an improvement in health knowledge (mean difference 27.28; 95% CI =26.15–28.41) and an improvement in health behavior (mean difference 23.54; 95% CI =22.60–24.48).

A modified HBM-based intervention to reduce BMI for age is effective in overweight junior high school students.

Immigrants, asylum seekers and refugees living in Europe face a number of challenges in accessing or using health information and healthcare services available in their host countries. To resolve these issues and deliver the necessary services, providers must take a comprehensive approach to better understand the types of health information and healthcare services that these individuals need, seek and use. Therefore, the purpose of this paper is to develop that comprehensive approach.

In this paper, a systematic literature review of peer-reviewed publications was performed, with 3.013 articles collected from various databases. A total of 57 qualifying papers on studies conducted in Europe were included in the review after applying the predefined inclusion and exclusion requirements, screening processes and eliminating duplicates. The information seeking and communication model (ISCM) was used in the analysis.

The findings revealed that while many health information and healthcare services are accessible in Europe for immigrants, asylum seekers and refugees, many of these individuals are unaware of their existence or how to access them. While our findings do not specify what health-related information these groups need, use or seek, they do suggest the importance and value of providing mental health, sexual health and HIV, as well as pregnancy and childbirth information and services. Furthermore, according to our results, health information services should be fact-based, easy to understand and raise awareness about healthcare structure and services available in Europe for this vulnerable population.

This study has a range of practical implications, including (1) highlighting the need for mental health and behavioural health services and (2) stressing the value of addressing cultural context and religious values while investigating (health) information seeking of people with foreign background.

This is one of the first studies to systematically review and examine the behaviour of immigrants, asylum seekers and refugees in relation to health information and healthcare services in the European context.

Prisoners have poorer oral health than the general population. Good oral health is essential for both social and physical well-being. For prisoners, poor oral health is also related to drug use after release, whereas good oral health is related to successful reintegration into society. The purpose of this study was twofold: to examine the effect of an intervention based on motivational interviewing (MI) on prisoners’ oral health-related behavior and to assess if the intervention is a good fit for this population.

In total, 16 prisoners in a Norwegian prison were offered a brief MI-based intervention focusing on changing their oral health-related behavior. An oral examination was also performed and the prisoners received a small package containing oral hygiene aids. Two weeks later, a second oral examination and a semi-structured interview were conducted to explore the effect of the intervention and examine the prisoners’ responses to the intervention. Qualitative data analyzes were guided by thematic analysis.

The findings indicate that the intervention had positive effects on both the prisoners’ motivation to use oral health-related behavior and their performance of oral health-related behavior. The findings also indicate that the intervention was well adapted to the target population.

This is one of the first studies that explore the effect of an intervention in improving prisoners’ oral health and bridges a knowledge gap in the literature. The findings may increase the understanding of how dental services should be organized and offered to provide dental health care to this vulnerable group.

The main objective of this study is to assess the applicability and robustness of the information motivation behavioural skills (IMB) model in determining dietary supplement usage of pregnant and breastfeeding women. More specifically, we examine the indirect effects of online social capital and internet use for health information on dietary supplement usage through self-efficacy and the moderating role of educational attainment.

Data was collected from 415 pregnant and breastfeeding Italian women using a self-administered questionnaire. Hypotheses were tested using Hayes's (2013) PROCESS macro for SPSS.

Internet use for health information is directly associated with dietary supplement usage. Online social capital and internet use for health information positively influence dietary supplement usage through self-efficacy. However, the results from moderated mediation analyses show that the mediation effects are moderated by educational attainment so that indirect relationships were stronger among women with a lower level of education than among those with a higher level of education.

Dietary supplement marketers and public health agencies can develop and implement dietary supplement promotional materials and interventions by disseminating information through the internet and social media and by strengthening social ties on online networking sites.

The originality of this study lies in the use of the IMB model as a theoretical framework to examine the mediating role of self-efficacy and the moderating role of education in explaining the mechanism of how online social capital and internet use for health information influence dietary supplement usage.

Exposure to unhealthy lifestyle behaviours before pregnancy affects the health of mothers and their (unborn) children. A social marketing strategy could empower prospective parents to actively prepare for pregnancy through preconception care (PCC). This study aims to describe the development of a PCC social marketing strategy based on the eight-point benchmark criteria for effective social marketing and to clarify the concept of using social marketing for health promotion purposes.

An extensive literature search was carried out regarding the needs of the target population and PCC behavioural goals, leading to the development of a bottom-up, ambassador-driven, communication concept.

In-depth insights of all benchmarks were analysed and incorporated during the development process of a new PCC social marketing strategy, with a special focus on the application of the “Health Belief Model” (Benchmark 3) and “the Four-P framework” (Benchmark 8). Evidence-based preconceptional health information is our product, for a low price as the information is freely attainable, promoting a message of overall women‘s health and online or through a consult with a health-care provider as the appropriate place. This formative research resulted in the development of the Woke Women® strategy, empowering women to actively prepare for pregnancy.

Developing a social marketing strategy to enhance actively preparing for pregnancy shows potential to encourage prospective parents to adopt healthier preconceptional lifestyle behaviours and can therefore improve the health of future generations.

This study investigates the effect of COVID-19 pandemic perceived health risk on traveller's post-pandemic perception and future travel intention. The study aims to provide insight into the unprecedented COVID-19 pandemic and its potential influence on tourist behaviour.

Two hundred and forty-four responses were gathered quantitatively through an online survey. The research hypotheses were analysed using the partial least square structural equation modelling (PLS-SEM).

This study found that COVID-19 affects tourists' travel behaviour. Key findings found that perceived health risk discourages travel attitudes and eventually lessens their future travel intentions. Results also suggest future strategies/directions for restarting the tourism industry.

The study outcome assists tourism stakeholders in understanding the changes in tourist behaviour amid the heightened perceived health risk of COVID-19. Tourism policymakers and industry players should consider exploring how to mitigate similar health crises in the future.

By extending the theory of planned behaviour (TPB), this study establishes a theoretical framework in exploring the interrelationships between perceived risk, post-pandemic perception and future travel intention. This study sets a significant research agenda for future tourism research in understanding the mechanism behind health risk perceptions and tourist behaviour.