Health Education and Health Promotion
Volume:11 Issue: 4, Fall 2023

Aims:

 Gestational diabetes is currently a medical complication in this period. This study was conducted with the aim of investigating the HAPA model in predicting diabetes control behavior and eating style in diabetic pregnant mothers referred to the health care centers of Abadan University of Medical Sciences (South of Iran) in year 2021.

Material & Method :

This cross-sectional study. The sample size was 85(d=0.05, p=0.06 and q=0.94) and subjects were selected  by using simple random sampling. Data were analyzed using SPSS 25 software.

Findings :

 41.5% of mothers were in the age group of 21-30 years. 43.9% of the people were at the middle economic level. Among demographic variables, income was the strongest predictor (p=0.01, R=19.9, β=-0.299).The result also showed none of model constructs alone predicted nutritional behavior in pregnant women. The HAPA model was able to predict 21% of the variance of the nutritional behavior (p<0.001, r=0.210, β=0.458) among subjects.

Conclusion:

 Consequences behavioral intention and action planning are effective in educating pregnant women for the prevention and control of diabetes.

Determining the effective factors in the use of e-learning among students can be useful in providing appropriate and practical solutions to increase the use of e-learning. Therefore, this study aimed to determine the factors related to the behavior of using e-learning among medical university students using the Technology Acceptance Model (TAM) as a conceptual framework.

This cross-sectional study was conducted among 425 students of Hamadan University of Medical Sciences who were selected by stratified random sampling. The data collection tool included demographic variables and TAM constructs. The data were analyzed in SPSS 23 software using statistical tests of one-way analysis of variance, independent t, Pearson correlation, and linear regression analysis.

The age range of the participants was between 18 and 54 years with an average age of 24.2 ± 3.96 years. The history of participating in e-learning classes was significantly related to all the constructs of the technology acceptance model (P<0.05). Also, undergraduate and graduate students had a significantly more positive attitude, higher perceived usefulness, and more usage intention and behavior in relation to e-learning than professional doctorate students (P<0.05). Attitude (β=0.394), perceived usefulness (β=0.313), and external variables (β=0.196) were respectively the strongest predictors of intention to use e-learning (P<0.05). The intention of e-learning usage directly and significantly predicted the behavior of using it (β=0.483, P<0.05).

The structures of the TAM predict the behavior of using electronic education among students.

The present study aimed to identify the predictors of hand hygiene intention and behavior among nurses using Theory of Planned Behavior.

This cross-sectional study was conducted in nurses working public hospital in Tehran, in 2016-2017. In total, 196 nurses were enrolled in this study and selected through random sampling. Data was collected using a self-administered questionnaire guided by TPB. For measuring validity of the questionnaire use of the opinions of 14 scholars and professors. Content Validity Ratio (CVR) was measured based on Lawshi method and Content Validity Index (CVI) was measured based on Waltz and Basel method. In addition, the methods of test-retest and internal consistency have been used for determination of reliability of the questionnaire. Data analysis was performed using SPSS software ver. 16.0 and statistical tests including multiple regressions.

Results indicated that attitude toward hand hygiene (P<0.001) and perceived subjective norms (P=0.012) were correlated with nurses’ intentions to hand hygiene. This set explained 56% of the variance in intention to hand hygiene. In addition, PBC was found as the strongest predictor of hand hygiene behavior (P<0.001), which together with subjective norms and intention have could predicted individuals’ behavior (R2=0.52).

Our findings suggest that constructs of the theory of planned behavior have predictability regarding hand hygiene behavior.

This study assessed the knowledge, attitude, and practice of general dentists in Rasht city, Iran, in 2022 regarding oral cancer.

This cross-sectional study was conducted on 129 randomly selected general dentists practicing in Rasht city, Iran in 2022. A researcher-designed questionnaire with 4 sections of demographics, knowledge (9 questions), attitude (7 questions), and practice (8 questions) was used for data collection after confirming its validity and reliability. Data were analyzed by the Chi-square test, Fisher’s exact test, and Pearson’s correlation test (alpha=0.05).

The mean knowledge score of the participants was 5.39±1.96 (out of 9). The majority of them (48.1%) had a moderate knowledge level. Knowledge level had a significant inverse correlation with age, time passed since graduation, and the attending university. The mean attitude score of the participants was 26.4±2.72 (out of 35). The majority of them (65.9%) had a positive attitude in this regard. Attitude had no significant correlation with any sociodemographic variable. The mean practice score of the participants was 18.18±2.53 (out of 24), and the majority of them (63.6%) had a moderate practice regarding oral cancer. Practice had a significant correlation only with participation in continuing education courses (P<0.05). Practice and knowledge, and also attitude and knowledge had a significant positive correlation with each other. 

The knowledge and practice of the majority of general dentists in Rasht were moderate regarding oral cancer, which is alarming and calls for improvement of the quality of instruction and holding continuing education courses.

This study compares two groups of twin pregnancies complicated by twin-to-twin transfusion syndrome (TTTS), with and without selective fetal growth restriction (sFGR), and evaluates the survival of 30 days after birth treated with FLP.

The present study was a retrospective study of 164 diamniotic monochorionic twin pregnancies complicated with TTTS and treated with FLP. sFGR was defined as an estimated fetal weight below the 10th percentile. Independent t-test, chi-square, or Fisher's exact test were used in statistical analysis. Multiple logistic regression analysis was performed to identify 30-day donor twin survival risk factors for the entire study population. Significance was determined at p < 0.05.

Of all the cases, 45.1% had TTTS-only, while 54.9% had both TTTS + sFGR.There was a significant difference (p<0.001) in the distribution of Quintero stages and maternal age during the intervention (p=0.01) between the two groups. This study concluded that sFGR before laser surgery in TTTS patients is associated with reduced donor survival. The multivariate analysis revealed that GA at delivery (OR = 0.81, 95% CI: 0.7-0.8) and sFGR (OR = 0.43, 95% CI: 0.2-0.8) were significantly associated with donor survival.

Performing successive ultrasounds after diagnosing monochorionic twin pregnancies is essential for timely identification, correct management, and treatment.

Indonesia is ranked as the 2nd highest country with tuberculosis burden worldwide. Diabetes mellitus (DM) is within the top 5 causes of death in Indonesia. Patients with DM are facing an elevated risk of tuberculosis. Private primary care centres only contributed up to 0.6% of the total reported tuberculosis case. The study focuses on developing an electronic tuberculosis screening for DM patients within private primary care centres to enhance tuberculosis notification rates.

The initial phase employs a quantitative approach, utilizing secondary data analysis from the RISKESDAS database to discern tuberculosis prevalence in DM patients. The second phase adopts a qualitative approach, incorporating interviews with private primary care centres regarding the current tuberculosis reporting process. The third stage involves system development of the e-screening tool itself. The fourth stage is a pilot project to evaluate the effectiveness of e-screening tool prototype in increasing tuberculosis notification rates among DM patients. Two private primary care centres served as a setting to conduct the pilot project.

There were 33 patients found to be of a high risk for tuberculosis. These patients were referred to the nearest Puskesmas for further tests. Ultimately, 2 patients were diagnosed with tuberculosis, in a span of 4 weeks e-screening trial test.

This research led to the development of TB e-screening tool for DM patients, intended to improve tuberculosis notification rates of private primary care centres.

Leishmaniasis is a skin disease spread by mosquitos from infected animals or humans to healthy humans. It can have a negative impact on your quality of life if you get it. The purpose of this study was to look into the impact of health worker training based on the PRECEDE model on the preventive behavior of the disease in covered households in Larestan, Iran.

This is a controlled semi-experimental study. The households served by comprehensive rural health centers in Larestan, Iran, were the target population. First, two comprehensive health centers were randomly assigned to one of two groups: intervention or control. Eighty of the covered households were divided into two groups. First, the intervention group's health workers received training in four face-to-face sessions. Health workers then trained the families who were covered by them. Both groups completed a researcher-made questionnaire before and two months after the intervention. The descriptive test, independent t test, paired t test, ANCOVA, and Cohen's D were used to analyze the data with SPSS20 software at a significance level of less than 0.05.

The mean of predisposing factors, enabling factors, reinforcing factors, and behavior in the intervention group after training differed significantly from the control group, and the effect size in each structure indicated that training had a positive effect.

The findings indicated that using the PRECEDE model in health worker training can play a significant role in adopting Leishmaniasis prevention behavior in people under their care.

The Covid-19 pandemic has an indirect effect on the psychology of postpartum mothers, such as stress, anxiety, and even depression levels. Postpartum women who have mental health histories are more at risk of facing depression, anxiety, and fear during the Covid-19 pandemic.

Objective of Research:

 This research aims to investigate the effect of psychoeducation through cultural approach bakera (maternity spa) to cure the anxiety of postpartum mother in the Covid-19 pandemic

This research design was quantitative, with a quasi-experimental approach to pretest and posttest in the control group and the experimental group. The instrument used a questionnaire to measure anxiety using the Zung Self-Rating Anxiety Scale (SAS/ SRAS).

The distinction of anxiety level between Bakera + Psychoeducation and Bakera group after treatment (posttest) is obtained Z value of 2.948 and a significance value of 0.003, so it was stated that there is a significant difference in the anxiety level between Bakera group + Psychoeducation and Bakera group after treatment (posttest).

There is an effect of psychoeducation through the cultural approach bakery (maternity spa) to cure the anxiety of postpartum mothers during the Covid-19 pandemic. There is a significant reduction in anxiety levels in the Bakera group + psychoeducation. There is a significant difference in anxiety levels between the Bakera + Psychoeducation group and the Bakera group after treatment (posttest).

Nurses need to think critically to provide effective care. They use critical thinking skills (CTS) every day to care based on the nursing process (NP). Caring and CT are at the core of professional nursing education. The aim of the study was to determine the relationship between NP blended learning methods and CT.

This study was a quasi-experimental cross-sectional educational evaluation, which was performed on 26 undergraduate students in their third semester at the Ramsar School of Nursing in 2022. According to the training program, these students were divided into four groups. Data were collected by the checklist of NP scores and California Critical Thinking Skills Test; form-B before and after a two-phase, six-day intervention with blended learning.

The paired t-test showed that except for the stage of review and recognition, this difference was significant for other states and the total score, which indicates the effect of the blended method on learning clinical NP in students. Before training, 95.7% of students had strong CT, which reached 100% after training. A significant relationship was observed between the total score of the second stage of clinical NP and deductive reasoning after training (p=0.04). There was no significant relationship between the total score of clinical NP and the total score of CT before and after training.

Blended learning methods should be considered in nursing curricula, and it seems that traditional methods cannot be successful in learning NP and CT.

Adolescents who suffer from chronic diseases, such as major thalassemia are more susceptible to physical, mental, emotional, spiritual, educational, and social self-care failure. These factors are generally more likely to be overcome if affected adolescents have a high level of self-care. This study aimed to assess self-care quality in adolescents with major thalassemia.

This descriptive cross-sectional study was performed on 200 adolescents with major thalassemia selected by convenience sampling. The Self-Care Assessment Questionnaire (SCAQ) with 52 items in six dimensions was used for data collection. Data were analyzed using descriptive statistics, independent t-test, Pearson correlation coefficient, and ANOVA.

There was no significant relationship between socio-demographic characteristics and the dimensions of self-care in participants. Adolescents with major thalassemia were found with a high score of quality of self-care. The highest mean scores were related to the dimensions of “emotional/mental self-care (2.44±0.64)”, “social self-care (2.08±0.61)”, and “spiritual self-care (2.07±0.62)”, respectively.

It is recommended that this issue be investigated in other adolescent patients, considering the importance of self-care and its effects on various aspects of quality of life in chronic diseases. Also, planning and implementing patient education is another important management measure to promote self-care in these adolescents.

Tuberculosis remains a significant public health challenge, impacting both productivity and mortality rates. The limited detection of TB cases can be attributed to inadequate funding, insufficiently trained staff, and ineffective educational resources for healthcare workers. This research aimed to develop an m-health tool, specifically a 'Health Corner,' to enhance understanding of tuberculosis screening and the successful treatment of tuberculosis.

This study employed a mixed methods approach, encompassing both design and development research. The intervention model underwent field testing using a quasi-experimental design involving a two-group pre-test post-test setup, with a control group comprising 60 randomly selected individuals from Legok Village, Jambi City, in September 2023. Data analysis comprised descriptive and inferential methods, including the t-test.

Health promotion material experts confirmed that the academic manuscript complied with the material requirements and aligned with the prototype under construction. Multimedia experts likewise endorsed the suitability of the M-HEALTH application for public use. Practitioner experts also confirmed that the M-HEALTH application was highly suitable for practical implementation. Field trial results revealed a significant increase in participants' knowledge levels after exposure to the M-HEALTH application. Average knowledge scores rose from 7.66 to 9.63 post-education, reflecting an average difference of 2.03 (p=0.001).

Using health education resources related to tuberculosis can effectively increase public awareness and knowledge about this disease.

Metacognitive processes are an aspect, through which students can significantly affect their learning process, allowing them to engage in multiple tasks simultaneously. This research was done to investigate the effectiveness of the metacognitive knowledge and skills program on visual and auditory dyslexia in students with learning disabilities.

This study employed a semi-experimental design with a pre-test-post-test approach and a control group. The study population consisted of all second- and third-grade elementary school students with learning disabilities in Tehran who were supervised in educational centers. The research sample consisted of 30 students with dyslexia (15 participants in the experimental group and 15 in the control group). The Wechsler Intelligence Scale was used to measure dyslexia. Descriptive analysis was employed to calculate means and standard deviations, while inferential analysis using analysis of covariance was used to analyze the data at an inferential level. Data were analyzed by SPSS 23.

The results showed the effectiveness of the Jager metacognitive knowledge and skills program in visual and auditory dyslexia in students with learning disabilities (p<0.001).

It can be generally concluded that the Jager metacognitive knowledge and skills program can mitigate the challenges of visual and auditory dyslexia in students with learning disabilities. It is recommended that this program be implemented for students with learning disabilities.

Effective uterine involution is crucial for preventing excessive postpartum bleeding. One of the factors influencing the pace of uterine involution is early breastfeeding combined with correct breastfeeding techniques. The aim of this study was to examine the impact of early breastfeeding and proper breastfeeding techniques on the acceleration of uterine involution in first-time mothers during the physiological postpartum period.

This experimental study employed a post-test design with a control group. The intervention group received early breastfeeding and education on correct breastfeeding techniques, whereas the control group did not receive such interventions. A total of 100 participants were randomly selected for the study, and data collection involved the use of checklist sheets and questionnaires. Data analysis was performed using the Mann-Whitney test.

Regarding early breastfeeding, both the intervention and control groups primarily initiated breastfeeding immediately after delivery. However, regarding the correct breastfeeding technique, the intervention group predominantly demonstrated good breastfeeding techniques, while the control group mainly exhibited sufficient techniques. Concerning the acceleration of uterine involution, the intervention group was predominantly categorized as having fast involution, while the control group exhibited slower involution (p<0.05).

There is a significant difference in the acceleration of uterine involution between the two study groups.

Professionalism encompasses clinical competence, communication skills, and ethical and legal awareness. The assessment of professional ethics varies among different groups based on their characteristics. This study aimed to develop and validate an ethical behavior intention instrument for medical students, based on the theory of planned behavior.

In this cross-sectional study, an item pool was generated based on an extensive literature review. Then, psychometric features, such as face validity (qualitative and quantitative), content validity (qualitative and quantitative), item analysis, and construct validity (exploratory factor analysis) were evaluated. Finally, the reliability was assessed using internal consistency (Cronbach's alpha).

A total of 200 medical students filled out the questionnaires, with a mean age of 21.84±4.47 years. In face validity, content validity ratio, and item analysis, six, nine, and three items were removed, respectively. In the exploratory factor analysis, six factors of gaining informed consent, accepting role limitations and collaborating with the treatment team, respect for colleagues and professors, abstract norms, perceived behavior control, and respect for patient values, needs, and culture together explained 51.128% of the total variance. Moreover, seven items were not included in any factor. The internal consistency of the entire questionnaire and its dimensions was acceptable.

The ethical behavior intention scale, which is designed based on the theory of planned behavior, is a valid and reliable scale that covers and measures the standards of professional ethics in medical students.

Healthcare workers are crucial in the healthcare sector, and understanding their educational prerequisites is of paramount importance. This study employed interpretive structural modeling to develop a comprehensive framework for elucidating these prerequisites in Iran.

We engaged 27 participants, including academic staff from the Universities of Medical Sciences and managers from the health and treatment network in Iran. Data were collected through self-administered questionnaires. The identified educational needs underwent validation using the Lawshe content validity index, resulting in a substantial content validity ratio (CVR) of 98%. Interpretive structural modeling was then applied to categorize and prioritize these educational needs.

The study unveiled nine essential educational needs for healthcare workers in Iran, covering domains, including effective communication skills, internet resource utilization, responsibility, work ethics, healthcare-related laws and regulations, decision-making and problem-solving abilities, teamwork, legal and ethical principles, management skills, and specialized healthcare knowledge, of which communication skills, internet resource utilization, responsibility, and work ethics emerged as the most influential factors.

This research offers valuable insights for the improvement of healthcare worker education and training programs in Iran.

Health literacy includes a range of critical skills that allow individuals to empower themselves to promote health behaviors. This study aimed to review the articles related to health literacy in the last 20 years and explain the factors associated with health literacy or predict it.

This systematic review examined quantitative research articles published from 2002 to 2022 and indexed in Scopus, PubMed, and Web of Science databases. 887 articles were retrieved, and based on inclusion/exclusion criteria, 55 articles were reviewed.Factors with the most frequent were reported and discussed. The role (prediction or association) was determined based on the highest frequency. The PRISMA 2009 framework was used to conduct a transparent process.

Younger people, white people, females, people with higher education levels, good social status, occupation, especially lifetime main occupations, higher individual income, higher knowledge level, and healthy people had high levels of health literacy. Also, the factors that had a significant relationship with health literacy (predictive or related) were different in patients and healthy people.

Health literacy includes various constructs and is related to different factors (as predictors or associated with health literacy). It may differ based on socio-economic and demographic characteristics in different communities.

The aim of this study was to analyze the effect of a combination of music therapy and breathing exercises on anxiety and physiological parameters in patients using mechanical ventilation.

The sample of this randomized controlled trial included 70 patients assigned to a treatment group of 35 patients and a control group of 35 patients. The proposed intervention was a combination of music therapy and deep breathing exercises carried out for 30 minutes twice a day for five days at 09:00 AM and 4:00 PM. In patients receiving mechanical ventilation, the following settings were used: synchronized intermittent mechanical ventilation, adaptive support ventilation, pressure support ventilation, continuous positive airway pressure, and duo positive airway pressure. Measurement of anxiety levels was done by the State-Trait Concern Inventory (Form Y) and assessing physiological parameters, such as blood pressure, mean arterial pressure, heart rate, respiration rate, and oxygen saturation. Data analysis was done using the paired t-test, Wilcoxon test, Mann-Whitney U test, and MANOVA at p<0.05.

Differences were observed between the two groups in anxiety levels (p=0.001), heart rate (p=0.001), and respiration rate (p=0.001). There were no differences between the two groups in systolic blood pressure (p=0.549), diastolic blood pressure (p=0.891), mean arterial pressure (p=0.571), and oxygen saturation (p=0.827).

The combination of music therapy with deep breathing exercises affects patient anxiety and physiological parameters with minimal risks.

Depression in Malaysia represents a significant and growing public health concern. With the current challenges in academic and university life, university students have become particularly vulnerable to depression and are unable to cope with stress. Accordingly, this study aimed to identify associative factors for depression among Malaysian students.

A cross-sectional study was conducted at public and private universities in Malaysia. A convenience sample of 1821 out of 1860 cases were approached and completed self-administered questionnaires, regarding depression (Patient Health Questionnaire-9) and their socio-demographic, academic, and psychosocial characteristics. A Chi-square test was conducted to find the relationship between the variables and depression, followed by multivariate logistic regression analysis to identify the predictors.

More than one-third (33.8%) of students scored clinical levels of depression. Financial support for the study, alcohol consumption, poor sleep quality, body mass index, and the global score for psychosocial characteristics were predictors of depression.

A high rate of depression in Malaysian students may be mitigated by addressing the influencing factors. Interventions, such as lifestyle change can reduce depression in this group.

Heart failure reduced ejection fraction (HFrEF) is defined as symptoms, such as shortness of breath and edema with an ejection fraction of less than 40% in echocardiography. Regarding the pathogenesis, the role of inflammation is undeniable. Interleukin 6 (IL-6) is one of the pro-inflammatory cytokines that is important in cardiovascular disease and has a critical role in CAD. It is also related to complications caused by heart failure and mortality. Nanocurcumin is a polyphenol extracted from the rhizome of Curcuma longa (turmeric) with better bioavailability. Effects of nanocurcumin on the reduction of IL-6 and NT-proBNP in hospitalized HFrEF patients with acute decompensation were investigated.

Sixty patients with HFrEF admitted with acute heart failure were divided into the intervention group with the administration of 40 mg of nanocurcumin twice a day for seven days and the control group (placebo). The levels of electrolytes, creatinine, IL-6, and NT-proBNP were measured at baseline and after one week.

There was no statistically significant difference in the reduction in IL-6 and NT-proBNP levels in the intervention and control groups (p>0.05). Also, there was no significant difference in creatinine and estimated glomerular filtration rate in the two groups (p>0.05).

Nanocurcumin at a dose of 40 mg twice a day for seven days in patients with acute decompensated heart failure did not reduce IL-6 and NT-proBNP levels.

Modernization and globalization have rendered teenagers susceptible to environmental influences, including risky sexual behaviors. Comic media, serving as a graphic medium, functions as a tool for simplifying complex topics, instilling value, captivating interest and attention, aiding in data interpretation, and condensing information. This research aimed to assess the effectiveness of health education utilizing digital comic media in promoting healthy reproductive behavior among adolescents.

This quasi-experimental research with a one-group pre-test-post-test design was done on 100 students. Statistical analysis was done using SPSS 16 by the Wilcoxon test.

There was an improvement of 3.2 in the behavior mean score from the pre-test to the post-test. The results of bivariate analysis using the Wilcoxon test on pre-test and post-test respondents revealed a p-value of 0.0001, which was less than 0.05. Therefore, there was a significant difference in knowledge and behavior between the pre-training and post-training stages using digital comics.

Health education delivered through digital comic media has a substantial impact on students’ knowledge and behavior, thereby contributing to the enhancement of healthy reproductive practices among teenagers at SMA N 01 Muaro Jambi.

Individuals are consistently influenced by maladaptive core beliefs known as incompatible schemas, which are formed in childhood and can contribute to the development of psychological disorders. Therefore, there is a need for effective interventions to address these schemas. The present study aimed to investigate the effectiveness of contextual schema therapy on body image and psychosomatic symptoms in individuals with perfectionism disorder.

This research used a quasi-experimental design with pre-test, mid-test, and post-test phases. In this regard, 12 participants diagnosed with perfectionism disorder were purposefully selected from individuals seeking psychological services in Tehran in 2022. Participants engaged in 40 sessions of 60 minutes each of contextual schema therapy, during which they responded to the Multidimensional Body-Self Relations Questionnaire and Psychosomatic Complaints Scale in all three phases. Data were analyzed using repeated measures analysis of variance.

The effectiveness of contextual schema therapy on body image and psychosomatic symptoms in individuals diagnosed with perfectionism disorder was found to be significant, and this difference was observed across all test phases (p<0.001).

Contextual schema therapy led to improvements in body image and psychosomatic symptoms. The application of this therapeutic approach is recommended for the enhancement of the mentioned disorders in individuals with perfectionism disorder.

Obesity in adolescent is associated with several negative outcomes. This study aimed to determine factors associated with obesity among female students during the COVID-19 pandemic.

In this descriptive correlational study, a convenience sample of female adolescent students of high schools in Tabriz, Iran (322 students who were classified as obese or overweight) was selected between January and May 2021. An online self-administered questionnaire was distributed through the Shad platform. The survey package included socio-demographic questions, health literacy measures for adolescents, an inventory of determinants of obesity-related behaviors in adolescents, and mother's nutritional literacy. Multiple regression analysis examined associated factors with obesity using SPSS 133. The study adhered to the STROBE guidelines for reporting.

The mean score of obesity-related behaviors was moderate (124.18±22.35). Participants' mean scores in the domains of lack of support, unhealthy nutrition, physical inactivity, and perceived inability were more than average. Adolescents' health literacy mean score was moderate (167.43±20.06). Mother’s occupation (β=15.73; 95% CI: 7.54 to 23.92; p<0.001) and mother's nutritional literacy (β=-0.88; 95% CI: -1.50 to -0.27; p=0.005) were statistically significant predictors of the obesity-related behavior.

Mothers' nutritional literacy plays a pivotal role in shaping adolescents' behaviors related to obesity; thus, empowering mothers with appropriate knowledge and skills in the field of healthier lifestyles and improving the overall well-being of adolescents is essential.