Journal of Health Promotion and Health Education

Children and Adolescents’ Views on Their Participation Rights Regarding Human Papillomavirus, COVID-19 Vaccines, and Health Care-Seeking: An Interview Study

2025-11-27T13:16:27+08:00

Objectives: Despite the rights to participation and to express opinions being enshrined in Articles 12-17 of the United Nations Convention on the Rights of Children (UNCRC), Children in Taiwan are not necessarily involved in discussions or decision-making on their own behalf. Children’s participation rights in vaccination contexts are essential as they encourage informed decisionmaking, build trust in health interventions, and allow children’s views to be considered regarding whether they receive a vaccine. This study explored children’s and adolescents’ understanding of their rights, participation rights, and participation and decision-making regarding receiving the COVID-19 and human papillomavirus vaccines and accessing healthcare.

Methods: Data were collected using purposive sampling, and 48 children and adolescents were interviewed. A thematic analysis approach was adopted to identify emerging themes in the interview transcripts.

Results: The findings revealed participants’ general awareness of children’s rights, parents’ respect for their diverse views on COVID-19 vaccination, and autonomy in HPV vaccine decisions. Participants also showed awareness of their health conditions and clearly expressed their willingness or refusal in health care decision-making.

Conclusions: Examining children’s and adolescents’ involvement in the vaccination process and healthcare highlights parents’ roles in the implementation of children’s rights. Concurrently, children and adolescents express their perspectives, and the development of decision-making capacities results from ongoing practice and life experiences.

A Study on the Knowledge, Attitudes, and Behavioral Intentions Regarding Artificial Intraocular Lens Implantation Among Patients

2026-03-23T14:17:18+08:00

Objectives: This study aimed to investigate the knowledge, attitude, and behavioral intention of patients toward intraocular lens (IOL) implantation, examine the associated factors, and analyze the correlations and predictive power
among these three constructs.

Methods: A cross-sectional survey was conducted using purposive sampling to recruit cataract patients aged 30 years and above from the ophthalmology outpatient clinic of a hospital in Taipei. A total of 114 valid questionnaires were
collected. The research instrument was a self-developed ‘Knowledge, Attitude, and Behavioral Intention toward IOL Implantation Questionnaire’, which had undergone expert review and pilot testing to establish reliability and validity.
Sociodemographic variables were also collected. Statistical analyses included descriptive statistics, independent-sample t-tests, one-way analysis of variance, Pearson’s correlation, and hierarchical multiple regression.

Results: The majority of participants were female, aged 65-74 years, had a technical college or university education, with moderate economic status, mostly living with family members, and reported no religious affiliation. Overall,
knowledge was at a moderate-to-high level, attitudes were positive, and behavioral
intentions were proactive. Knowledge was significantly associated with economic
status (F = 9.456, p < .001) and surgical experience (t = 2.909, p = .005). Attitude was significantly associated with education level (F = 6.69, p = .002), economic status (F = 5.29, p = .006), cohabitation status, and religious affiliation. Behavioral
intention showed no significant association with sociodemographic variables. All three constructs were positively correlated, with attitude emerging as a significant predictor of behavioral intention (β = 0.534, p < .001, ΔR² = 0.192).

Conclusions: Enhancing knowledge and fostering positive attitudes may strengthen IOL implantation surgical decision-making. Health institutions should reinforce education and communication, particularly through tailored interventions for patients with insufficient knowledge and less favorable attitudes, to improve surgical accessibility and promote visual health.

Health Literacy Among Women with Infertility Undergoing Assisted Reproductive Technology: A Qualitative Focus Group Study

2026-04-08T11:49:43+08:00

Objective: This study explored health literacy and treatment experiences among women with infertility undergoing assisted reproductive technology (ART), based on Nutbeam’s three-level framework.

Methods:A qualitative focus group design was used. Six women receiving
ART at a medical center in northern Taiwan were recruited in August 2022. Data were transcribed verbatim and analyzed using content analysis. Themes were categorized into functional, interactive, and critical health literacy.

Results:The findings revealed that health literacy and treatment experiences
were dynamically intertwined and mutually influential. Functional health literacy was reflected in understanding infertility-related knowledge and treatment procedures, proper medication use, and recognition of side effects. Interactive health literacy was demonstrated through patient–provider communication, use of digital tools, and utilization of social support. Critical health literacy involved evaluating information credibility, understanding treatment costs and subsidy policies, and making treatment decisions. In addition, participants experienced treatment-related stress, emotional responses, and life adjustments, with health literacy developing across levels throughout the treatment process.

Conclusion:Health literacy and treatment experiences among women with
infertility are closely interconnected, primarily manifesting at the functional and interactive levels, while critical health literacy remains underdeveloped. Clinical
practice should provide stage-based health education, psychological support, and decision aids. At the policy level, improving the transparency and accessibility of ART subsidy programs is recommended to enhance health literacy and support informed medical decision-making.

Effects of a Positive Mental Health Classroom Management Intervention on Junior High School Students

2026-04-24T11:07:35+08:00

Objectives: Adolescents increasingly experience academic stress, emotional distress, and interpersonal difficulties. This study investigated the effects of a positive mental health classroom management intervention on junior high school students’ efficacy and behaviors related to PERMA (positive emotion, engagement, relationships, meaning, and accomplishment) and PLUS (physical activity, leisure activities, nutrition, and sleep), as well as their overall positive mental health and perceptions of classroom climate.

Methods: A mixed-methods design was employed. Participants were 99 seventh-grade students from four classes at a junior high school in New Taipei City, Taiwan. The 6-week intervention was implemented from March to May 2025 and included positive mental health board games, weekly calendar-based materials, instructional activities, and classroom environment enhancement strategies. Data were collected using questionnaires and student feedback forms. Quantitative data were analyzed using paired-sample t tests, and qualitative data were used to
complement and contextualize the quantitative findings.

Results: The intervention significantly improved students’ positive engagement, including academic preparation and proactive learning, as well as their physical activity behaviors. However, no significant pre–post differences were observed in overall PERMA-PLUS outcomes or positive mental health. Qualitative findings suggested that most students evaluated the program positively and reported enhanced understanding of positive mental health concepts, together with improvements in emotional adjustment, interpersonal interaction, and healthy behaviors.

Conclusions: Positive mental health classroom management may enhance junior high school students’ positive engagement efficacy and physical activity behaviors. Future efforts should consider school-wide implementation of social and emotional learning and stronger collaboration among teachers, parents, and students to further promote the development and practice of PERMA-PLUS.